Dear Dr. D.

The other day my boyfriend and I got into a fight about hand sanitizer. He thinks that you should use anti-bacterial soap or hand sanitizer every time you wash your hands. I, the science major, contradicted him and said that I would only be using it in a medical setting because using it too much can actually be harmful. Please help me prove to him that I am right this time.

Oh so perfect hands

Dear OSPH,

Finally, a question about "suds," and it has absolutely nothing to do with beer! I've got to "hand" it to you, this question has me in a "lather!" I can even get on my "soapbox" and not feel bad about having to justify it. I just love a question which simultaneously lets me educate, explore myths and use puns all at the same time. OK, I'm all "washed" out for now … Isn't life good!

Seriously, your question does give me an opportunity to educate about germ (bacteria and virus) transmission and why this is important to MSU students. Consider the following: We are in the middle of cold and flu season, and MSU students who live on campus reside in some of the largest contained living spaces in the United States. This factor results in a lot of folks worrying excessively about passing or catching unwanted germs especially when living in close proximity with others. The best way to stop most of this handwringing is with accurate knowledge about how to help keep yourself clean.

Whether it freaks you out or not, almost all hands have what we call normal flora. Those are the germs that are normally present on the hands and help keep pathogens, the germs that would cause infections, in line. In most cases this normal flora works pretty well, and we should try not to disturb it, although we do need to think about giving our hands a little help during cold and flu season.

Your question really references three different kinds of products: instant hand sanitizers, which include alcohol as the primary killing ingredient; antibacterial soaps, which mostly contain triclosan, an antibacterial agent which kills bacteria; and regular soap and water. Studies are inconclusive as to whether antibacterial soap really does help prevent infection any better than regular soap. This, combined with the fact that it also can kill the normal flora just as instant hand sanitizers, allows me to confine the discussion to only hand sanitizers versus soap and water.

Hand sanitizers, which have become popular and been on the market for some time, are used extensively in medical settings, where it is welcomed for both its convenience and effectiveness. This effectiveness is also the main drawback for normal users in everyday use. It kills the germs on our hands — all of them — good and bad. This removal of the normal flora could give rise and contribute to the growth of stronger antibiotic resistant germs (pathogens).

The active ingredient in most of these instant hand sanitizers is alcohol, which can wipe out germs indiscriminately and with repeated use can cause serious drying of the skin. This can lead to cracks and breaks in the skin which could reduce the overall effectiveness of the skin as an infection barrier.

Who knew that plain soap and water could be the best way to prevent the spread of colds and flu, as well as other pesky pathogens? Using ordinary soap (liquid soap is my favorite), warm water and some friction, you can send those perky pathogens down the drain. You see, it is all about the friction and the amount of time you spend scrubbing. After you apply the soap, you should lather the whole of the hands for about 20 seconds, or about the time it takes to sing "Twinkle, Twinkle, Little Star." Most people fail by not spending enough time scrubbing.

What happens is that those pesky pathogens don't necessarily die; they mostly just lose their hold on the hands and when you rinse they go down the drain. Remember to dry hands using clean paper towels or cloth afterwards. It is also a good idea to use paper towels when turning off the water tap, especially when using a public facility.

A good rule of thumb is to wash your hands before and after handling or eating food; sneezing, blowing your nose or coughing; tending to someone who is sick; playing outside or with pets; and after using the bathroom. Hand sanitizers do have their place and are great in an emergency, but for everyday cleansing, warm water and maybe a good moisturizing soap is the best. You can tell your boyfriend that your reasoning beats his — hands down. Peace.

Dr. D.